Abstract
Tracheostomy, a surgical procedure creating an artificial airway in the trachea, has evolved significantly since 1999 in pediatric care, driven by technological advancements and a deeper understanding of pediatric respiratory physiology. While once reserved for emergency situations or as a last resort for airway obstruction, its role has expanded to encompass long-term respiratory support, chronic aspiration management, and improved quality of life for children with complex medical conditions. The aim of this review, although not systematic, is to provide insight for pediatric surgeons, pulmonologists, critical care physicians, and other healthcare professionals involved in the care of children with tracheostomies.